Counselling Survey

This survey could be adapted to suit different patient needs. This particular survey is aimed at patients who are supported at Oncology/Breast cancer units.

1

How did you find out about the counselling service offered by the Oncology/Breast cancer unit?

2

Once it was agreed that a referral to the counsellor would be helpful, how long was it before the counsellor contacted you?

3

Were you happy with the response time?

4

Did you feel that the counselling referral was made at the appropriate time for you?

5

Once your counselling started, how easy was it for you to make contact with the counsellor if you needed to?

6

Did you proceed with the counselling?

If you answered YES to Q6 then please answer these questions, otherwise thank you for your time.

7

How many sessions with the counsellor did you have?

8

Would you have liked more sessions?

9

Were you taught any relaxation Techniques?

10

If YES, did you find this a useful technique to help you manage your anxiety?

11

Were you taught other ways to manage stress?

12

If YES, were they helpful?

13

Would you find it helpful to be offered complementary therapies, such as aromatherapy massage and reflexology?

14

Did you find the room in which the counselling session took place:

Yes

No

Comfortable?

Welcoming?

Offered privacy?

15

Please use this space to make any further comments on the room:

16

How would you rate the usefulness of seeing the counsellor?

17

In what ways have you found the counselling helpful or unhelpful?

18

Please use this space to elaborate on your answers or to make any further comments;

Thank you for providing your feedback.

Created by KeyPoint survey software